Agency/Intermediary Code - irdai
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Transcript of Agency/Intermediary Code - irdai
Part A
<<Date>>
<<Policyholder’s Name>>
<<Policyholder’s Address>>
<<Policyholder’s Contact Number>>
Dear <<Policyholder’s Name>>,
Sub: Your Policy no. <<>>
We are glad to inform you that your proposal has been accepted and the HDFC Life New
Immediate Annuity Policy (“Policy”) being this Policy, has been issued. We have made every
effort to design your Policy in a simple format. We have highlighted items of importance so
that you may recognise them easily.
Policy document:
As an evidence of the insurance contract between HDFC Life Insurance Company Limited
and you, the Policy is enclosed herewith. Please preserve this document safely and also
inform your Nominee(s)about the same. A copy of your proposal form and other relevant
documents submitted by you are also enclosed for your information and record.
Cancellation in the Free-Look Period:
In case you are not agreeable to any of the provisions stated in the Policy, you have the
option to return the Policy to us stating the reasons thereof, within 15 days from the date of
receipt of the Policy. If you have purchased your Policy through Distance Marketing mode,
this period will be 30 days. However this option will not be available in the event of purchase
of this Policy from the vesting proceeds of an accumulation pension product previously
purchased by you. On receipt of your letter along with the original Policy, we shall arrange to
refund the Premium/Purchase Price paid by you subject to deduction of the expenses incurred
by us for medical examination (if any) and stamp duty (if any).
If this product is purchased as QROPS through transfer of UK tax relieved assets, the
proceeds from cancellation in free look period shall only be transferred back to the Fund
House from where the money was received.
Contacting us:
The address for correspondence is specified below. To enable us to serve you better, you are
requested to quote your Policy number in all future correspondence. In case you are keen to
know more about our products and services, we would request you to talk to our authorized
representatives or Certified Financial Consultant (Insurance Agent) who has advised you
while taking this Policy. The details of your Certified Financial Consultant including contact
details are listed below.
To contact us in case of any grievance, please refer to Part G. In case you are not satisfied
with our response, you can also approach the Insurance Ombudsman in your region.
Thanking you for choosing HDFC Life Insurance Company Limited and looking forward to
serving you in the years ahead,
Yours sincerely,
<< Designation of the Authorised Signatory >>
Branch Address: <<Branch Address>>
Agency/Intermediary Code: <<Agency/Intermediary Code>>
Agency/Intermediary Name: <<Agency/Intermediary Name>>
Agency/Intermediary Telephone Number: <<Agency/Intermediary mobile &
landline number>>
Agency/Intermediary Contact Details: <<Agency/Intermediary address>>
Address for Correspondence: HDFC Life Insurance Company Limited, 11th Floor Lodha
Excelus, Apollo Mills Compound, N.M. Joshi Marg, Mahalaxmi, Mumbai-400011.
Registered Office: Lodha Excelus, 13th Floor, Apollo Mills Compound, N. M. Joshi Marg,
Mahalaxmi, Mumbai - 400 011.
Call1860-267-9999(local charges apply).DO NOT prefix any country code e.g.
+91or00.Available all days
From 9 am to 9 pm |Email – [email protected] | [email protected] (For NRI
customers only) Visit– www.hdfclife.com. CIN: L65110MH2000PLC128245.
POLICY DOCUMENT- HDFC Life New Immediate Annuity
Unique Identification Number: UIN- 101N084V19
Your Policy is a single premium non-participating and non linked annuity policy. This document is the
evidence of a contract between HDFC Life Insurance Company Limited and the Annuitant as described in
the Policy Schedule given below. This Policy is based on the Proposal made by the within named
Annuitant and submitted to the Company along with the required documents, declarations, statements, and
other information received by the Company from the Annuitant or on behalf of the Annuitant. This Policy
is effective upon receipt and realisation, by the Company, of the consideration payable as
Premium/Purchase Price under the Policy. This Policy is written under and will be governed by the
applicable laws in force in India and all Premium/Purchase Price and Benefits are expressed and payable
in Indian Rupees.
POLICY SCHEDULE
Policy number: <<>>
Client ID: <<>>
Policyholder Details
Name <<>>
Address <<>>
Annuitant Details
Annuitant Information Annuitant/Primary Annuitant Secondary Annuitant
Name <<>> <<>>
Date of Birth << dd/mm/yyyy >> << dd/mm/yyyy >>
Age on the Date of Risk
Commencement <<>> years
<<>> years
Age Admitted <<Yes/No>> <<Yes/No>>
Policy Details
Date of Commencement of Policy <<Date>>
Date of Risk Commencement << RCD >>
Date of Issue/Inception of Policy << Issue Date>>
Premium/Purchase Price Payment
Date <<dd /month>>
Plan Option <<>>
Benefits payable on Death Rs. <<>>
Benefits payable on diagnosis of
Critical Illness Rs. <<>>/<<Not Applicable>>
Guarantee Period <<>>/<<Not applicable>>
Premium/Purchase Price Paid Rs. <<>>>
Frequency of Annuity Payment << Annual/Half-yearly/ Quarterly/ Monthly >>
Annuity Amount per Frequency of
Annuity Payment Rs. <<>>
Riders
Rider Name <<>>
Rider Term <<>> years
Rider Sum Assured Rs. <<>>
The Premium/Purchase Price amount is excluding any tax and levies as applicable leviable on the
Premium/Purchase Price. Amount of tax and levies will be charged at actuals as per prevalent rate.
NOMINATION SCHEDULE
Nominee’s Name <<Nominee-1 >> <<Nominee-2 >>
Nominee’s Relationship with
the Life Assured <<>> <<>>
Date of Birth of Nominee << dd/mm/yyyy >> << dd/mm/yyyy >>
Nominee’s Age <<>>years <<>>years
Nomination Percentage <<>> % <<>> %
Nominee's Address <<>> <<>>
Appointee’s Name
<<>> (Applicable where the Nominee
is a minor)
Date of Birth of Appointee << dd/mm/yyyy >>
Appointee's Address <<>>
Signed at Mumbai on <<>>
For HDFC Life Insurance Company Limited
Authorised Signatory
Note: Kindly note that name of the Company has changed from “HDFC Standard Life Insurance Company
Limited” to “HDFC Life Insurance Company Limited”
In case you notice any mistake, you may return the Policy document to us for necessary
correction.
SPACE FOR ENDORSEMENTS
Part B
(Definitions)
Definitions in alphabetical order
1) Annuitant – means the person who is entitled to receive the annuity benefits and on
whose life the contingent events have to occur for the Benefits to be payable as stated
in the Policy Schedule.
2) Appointee – means the person named by you and registered with us in accordance
with the Nomination Schedule, who is authorised to receive the Death Benefit under
this Policy on the death of the Annuitant while the Nominee is a minor;
3) Authority/ IRDAI – means Insurance Regulatory and Development Authority of
India;
4) Company, company, Insurer, Us, us, We, we, Our, our – means or refers to HDFC
Life Insurance Company Limited.
5) Date of Risk Commencement – means the date, as stated in the Policy Schedule, on
which the insurance coverage under this Policy commences;
6) Guarantee Period – means the period, as stated in the Policy Schedule, which is
chosen by you at the time of Policy inception, for which the annuity is guaranteed to
be payable to the Annuitant or his/her Nominee upon the Annuitant’s death.
7) Nominee(s) – means the person(s) named by you and registered with us in accordance
with the Nomination Schedule, who is authorised to receive the Death Benefit under
this Policy, on the death of the Annuitant;
8) Medical Practitioner – means a person who holds a valid registration from the
medical council of any state of India and is thereby entitled to practice medicine
within its jurisdiction and is acting within the scope and jurisdiction of his license but
excluding the Practitioner who is:
a) Annuitant/Policyholder himself or an agent of the Annuitant/ Policyholder;
b) Insurance Agent, business partner(s) or employer/employee of the Annuitant/
Policyholder or;
c) A member of the Annuitant's/ Policyholders immediate family.
9) Policy Anniversary – means the annual anniversary of the Date of Risk
Commencement;
10) Policyholder, You, you, your – means or refers to the Policyholder stated in the Policy
Schedule. The Policyholder is the owner of the Policy.
11) Policy Term – means the term of the Policy as stated in the Policy Schedule;
12) Premium/Purchase Price – means an amount stated in the Policy Schedule, payable
by you to us and in the manner stated in the Policy Schedule, to secure the benefits
under this Policy, excluding taxes and levies;
13) Primary Annuitant – refers to the individual, the events in the life of whom are of
primary importance in affecting the timing or amount of payout under the contract.
14) Secondary Annuitant – refers to the second life for the purpose of joint life Annuity
option
15) Sum Assured - mean the absolute amount of benefit which is guaranteed to become
payable as per the terms and conditions specified in the Policy
16) Surrender - means complete withdrawal/ termination of the entire Policy.
17) Surrender Value - means an amount, if any, that becomes payable in case of
Surrender of the Policy in accordance with the terms and conditions of the Policy.
Part C
(Benefits)
1. Benefits:
(1) Annuity Option - Under this Policy, the amount of Benefit depends on the annuity
option and the frequency selected. The table below sets out the annuity benefits for
various options:
Annuity Option Annuity Benefits
<<Life Annuity
Annuity payments will be made in arrears for
as long as the Annuitant is alive. The annuity
payments will cease on death of the
Annuitant>>
<<Life Annuity with Return of
Premium/Purchase Price
<<Life Annuity with Return of Balance
Premium/Purchase Price
<<Life Annuity with Return of
Premium/Purchase Price in Parts
<<Life Annuity with a Guarantee Period Annuity payments will be made in arrears for
as long as the Annuitant is alive or until the
end of the Guarantee Period, whichever is
later. The annuity payments will cease on the
later of:
- death of the Annuitant; or
- completion of the Guarantee Period.
The Guarantee Period shall be as selected by
you and is set out in the Policy Schedule>>
<<Life Annuity with 5% escalation Annuity payments will be made in arrears for
as long as the Annuitant is alive. The annuity
payment will increase at a simple rate of 5%
per annum of the initial annuity payment.
For example, if the annuity amount is
Rs10,000 in the first year; the annuity will be
Rs10,500 in the second year; Rs11,000in the
third year and so on. The annuity payments
will cease on the death of the Annuitant>>
<<Life Annuity with Return of
Premium/Purchase Price on diagnosis of
Critical Illness
Annuity payments will be made in arrears.
The annuity payments will cease on the
earlier of:
- being diagnosed with a specified Critical
Illness as mentioned in the Part C Clause
1(4) before the age of 85; or
- death of the Annuitant>>
<<Joint Life Annuity with 100% annuity to
the Secondary Annuitant
100% of the annuity amount will be payable
in arrears so long as either the Primary
<<Joint Life Annuity with 100% annuity to
the Secondary Annuitant and return of
Premium/Purchase Price
Annuitant or the Secondary Annuitant is
alive. The annuity payments will cease on
later of the deaths of the two Annuitants>>
<<Joint Life Annuity with 50% annuity to the
Secondary Annuitant
100% of the annuity amount will be payable
in arrears so long as the Primary Annuitant is
alive. On the death of the Primary Annuitant,
50% of the annuity amount will be payable to
the Secondary Annuitant as long as the
Secondary Annuitant is alive. The annuity
payments will cease on later of the deaths of
the two Annuitants. If the Secondary
Annuitant predeceases the Primary
Annuitant, the annuity payments shall cease
upon the death of the Primary Annuitant>>
<<Joint Life Annuity with 50% annuity to the
Secondary Annuitant and return of
Premium/Purchase Price
(2) Death Benefit (Payable to Nominee/Legal heirs) - The Death Benefit will vary
depending on the annuity option. The table below sets out the Death Benefit for the
various options:
Annuity Option Death Benefits
<<Life Annuity None>>
<<Life Annuity with Return of
Premium/Purchase Price
100% of the Premium/Purchase Price of the
annuity will be paid to the Nominee(s)>>
<<Life Annuity with Return of
Balance Premium/Purchase Price
Excess, if any, of 100% of the Premium/Purchase
Price of the annuity less the aggregate of all
annuity installments previously paid to the
Annuitant will be paid to the Nominee(s)>>
<<Life Annuity with a Guarantee
Period
None>>
<<Life Annuity at 5% escalation None>>
<<Life Annuity with Return of
Premium/Purchase Price in Parts On
death of the Annuitant before the seventh
Policy Anniversary 100% of the
Premium/Purchase Price will be paid to the
Nominee(s)
On
death of the Annuitant after the seventh
Policy Anniversary 70% of the
Premium/Purchase Price will be paid to the
Nominee(s)>>
<<Life Annuity with Return of
Premium/Purchase Price on
diagnosis of Critical Illness
100% of the Premium/Purchase Price of the
annuity will be paid to the Nominee(s)>>
<<Joint Life Annuity with 100%
annuity to the Secondary
Annuitant
None>>
<<Joint Life Annuity with 50% None>>
annuity to the Secondary
Annuitant
<<Joint Life Annuity with 100%
annuity to the Secondary
Annuitant and return of
Premium/Purchase Price
100% of the Premium/Purchase Price of the
annuity will be paid to the Nominee(s)>>
<<Joint Life Annuity with 50%
annuity to the Secondary
Annuitant and return of
Premium/Purchase Price
100% of the Premium/Purchase Price of the
annuity will be paid to the Nominee(s)>>
The Premium/Purchase Price referred in the table above excludes tax and levies if applicable.
In case of any annuity payments being made between the date of death and the date of
intimation of such death, such annuity payments will be deducted from the death benefit
wherever applicable.
<< (3) Survival Benefit –
Life Annuity with Return of Premium/Purchase Price in Parts: Under the option Life
Annuity with Return of Premium/Purchase Price in parts, on the seventh Policy
Anniversary, 30% of the Premium/Purchase Price is payable provided the Annuitant
is alive.
(4) Benefits payable on diagnosis of Critical Illness:
Life Annuity with Return of Premium/Purchase Price on diagnosis of Critical Illness:
Annuity payments will be made in arrears. The annuity payments will cease on the
earlier of:
(a) being diagnosed with a specified Critical Illness as mentioned below before the age of
85; or
(b) death of the Annuitant.
Under the option Life Annuity with Return of Premium/Purchase Price on diagnosis
of Critical Illness, the Premium/Purchase Price excluding tax and other levies will be
paid to the Annuitant upon the diagnosis of the following Critical Illnesses:
a) Cancer of Specified Severity
A malignant tumor characterized by the uncontrolled growth and spread of malignant
cells with invasion and destruction of normal tissues. This diagnosis must be
supported by histological evidence of malignancy. The term cancer includes
leukemia, lymphoma and sarcoma.
The following are excluded –
i. All tumors which are histologically described as carcinoma in situ, benign, pre-
malignant, borderline malignant, low malignant potential, neoplasm of unknown
behavior, or non-invasive, including but not limited to: Carcinoma in situ of breasts,
Cervical dysplasia CIN-1, CIN -2 and CIN-3.
ii. Any non-melanoma skin carcinoma unless there is evidence of metastases to lymph
nodes or beyond;
iii. Malignant melanoma that has not caused invasion beyond the epidermis;
iv. All tumors of the prostate unless histologically classified as having a Gleason
score greater than 6 or having progressed to at least clinical TNM classification
T2N0M0
v. All Thyroid cancers histologically classified as T1N0M0 (TNM Classification) or
below;
vi. Chronic lymphocytic leukaemia less than RAI stage 3
vii. Non-invasive papillary cancer of the bladder histologically described as TaN0M0
or of a lesser classification,
viii. All Gastro-Intestinal Stromal Tumors histologically classified as T1N0M0 (TNM
Classification) or below and with mitotic count of less than or equal to 5/50 HPFs;
b) Open Chest CABG
The actual undergoing of heart surgery to correct blockage or narrowing in one or
more coronary artery(s), by coronary artery bypass grafting done via asternotomy
(cutting through the breast bone) or minimally invasive key hole coronary artery
bypass procedures. The diagnosis must be supported by a coronary angiography and
the realization of surgery has to be confirmed by a cardiologist.
The following are excluded:
i. Angioplasty and/or any other intra-arterial procedures
c) Myocardial Infarction
The first occurrence of heart attack or myocardial infarction, which means the death
of a portion of the heart muscle as a result of inadequate blood supply to the relevant
area. The diagnosis for Myocardial Infarction should be evidenced by all of the
following criteria:
i. A history of typical clinical symptoms consistent with the diagnosis of acute
myocardial infarction (For e.g. typical chest pain)
ii. New characteristic electrocardiogram changes
iii. Elevation of infarction specific enzymes, Troponins or other specific biochemical
markers.
The following are excluded:
i. Other acute Coronary Syndromes
ii. Any type of angina pectoris
iii. A rise in cardiac biomarkers or Troponin T or I in absence of overtischemic heart
disease OR following an intra-arterial cardiac procedure.
d) Kidney Failure Requiring Regular Dialysis
End stage renal disease presenting as chronic irreversible failure of both kidneys to
function, as a result of which either regular renal dialysis (hemodialysis or peritoneal
dialysis) is instituted or renal transplantation is carried out. Diagnosis has to be
confirmed by a specialist medical practitioner.
e) Major Organ Transplant (as recipient)
I. The actual undergoing of a transplant of:
i. One of the following human organs: heart, lung, liver, kidney, pancreas, that
resulted from irreversible end-stage failure of the relevant organ, or
ii. Human bone marrow using haematopoietic stem cells. The undergoing of a
transplant has to be confirmed by a specialist medical practitioner.
II. The following are excluded:
i. Other stem-cell transplants
ii. Where only islets of langerhans are transplanted
f) Stroke Resulting In Permanent Symptoms
Any cerebrovascular incident producing permanent neurological sequelae. This
includes infarction of brain tissue, thrombosis in an intracranial vessel, haemorrhage
and embolisation from an extracranial source. Diagnosis has to be confirmed by a
specialist medical practitioner and evidenced by typical clinical symptoms as well as
typical findings in CT Scan or MRI of the brain. Evidence of permanent neurological
deficit lasting for at least 3 months has to be produced.
The following are excluded:
i. Transient ischemic attacks (TIA)
ii. Traumatic injury of the brain
iii. Vascular disease affecting only the eye or optic nerve or vestibular functions.>>
(5) The Death Benefit is subject to the exclusions set out in Part F Clause 1 (Exclusions).
(6) Upon the payment of the Death Benefit or the Annuity Benefit, or Benefits payable on
diagnosis of Critical Illness whichever is earlier, the Policy terminates and no further
Benefits are payable.
(7) The recipients of Benefits under this Policy shall be as specified below:
(i) Death Benefit shall be payable to the registered Nominee(s), if the Policyholder and
the Annuitant are the same; or to the Policyholder if the Annuitant is other than the
Policyholder.
(ii) All other Benefits shall be payable to the Annuitant.
(iii)In case of any unique situation or doubt the Company’s decision will be final and
binding.
2. Payment and cessation of Premium/Purchase Price (1) Where the Premium/Purchase Price has been remitted otherwise than in cash, the
application of the Premium/Purchase Price received is conditional upon the
realization of the proceeds of the instrument of payment, including electronic mode.
Part D
(Policy Servicing Aspects)
1. Alterations
No alterations are permissible under the Policy.
2. Loans
No loans will be provided on your Policy.
3. Free Look Cancellation
In case the Policyholder is not agreeable to any of the terms and conditions stated in the
Policy, the Policyholder has an option to return the Policy to the Company stating the
reasons thereof, within 15 days from the date of receipt of the Policy. If the Policy has
been purchased through Distance Marketing mode, this period will be 30 days. However
this option will not be available in the event of purchase of this Policy from the vesting
proceeds of an accumulation pension product previously purchased by you. On receipt of
the Policyholder’s letter along with the original Policy document where the reasons stated
therein are found valid, the Company shall arrange to refund the Premium/Purchase Price
paid subject to deduction of the expenses incurred by us for medical examination (if any)
and stamp duty (if any).
If this product is purchased as QROPS through transfer of UK tax relieved assets, the
proceeds from cancellation in free look period shall only be transferred back to the Fund
House from where the money was received.
(4) Surrender Benefits
Surrender Benefits are available for the following three options only. The table below sets
out the Surrender Benefits as per the annuity option chosen by you:
Annuity Option Surrender Benefits
Life Annuity with Return of Purchase Price 10% of the Premium/Purchase Price
Life Annuity with Return of Purchase Price
on diagnosis of Critical Illness
10% of the Premium/Purchase Price
Life Annuity with Return of Purchase Price in
parts
10% of the Premium/Purchase Price if
surrendered within 7 years from the date of
risk commencement, 7% of the
Premium/Purchase Price if surrendered
thereafter
Surrender Benefits are not available for any other Annuity Option.
In addition, the Company may pay a Special Surrender Value depending on the prevailing
market conditions.
Currently, the Special Surrender Value (SSV) is the same as Guaranteed Surrender Value.
The SSV may be revised from time to time with prior approval of the Authority.
For the purpose of computing the Surrender Benefits, the Premium/Purchase Price
excludes tax and levies if applicable.
Part F
(General Terms & Conditions)
1. Exclusions
There are no exclusions under this Policy.
2. Age Admitted
The Company has calculated the Premium/Purchase Price under the Policy on the basis
of the age of the Annuitant as declared in the Proposal. In case you have not provided
proof of age of the Annuitant with the Proposal, you will be required to furnish such
proof of age of the Annuitant as is acceptable to us and have the age admitted. In the
event the age so admitted (“Correct Age”) during the Policy Term is found to be
different from the age declared in the Proposal, without prejudice to our rights and
remedies including those under the Insurance Act, 1938 as amended from time to time,
we shall take one of the following actions:
i) If eligible, and if the Correct Age is found to be higher, the benefit payable under this
Policy, Rider, if any, shall be after deduction of such difference of Premium/Purchase
Price (i.e difference in Premium/Purchase Price paid based on age declared in the
Proposal and Premium/Purchase Price based on the Correct Age) along with interest
thereon. In such cases, before calculating the amount of benefit payable, the Policy
shall be subject to re-underwriting and the Sum Assured shall be subject to eligibility as
per underwriting norms and the Premium/Purchase Price to be deducted shall be
calculated proportionately on such Sum Assured payable. If the Correct Age is found
to be lower, excess Premium/ Purchase Price without any interest shall be refunded.
ii) If ineligible for the Policy basis the Correct Age, the Policy shall be void-ab-initio
and the total Premium/Purchase Price paid shall be refunded without interest after
deducting the annuity already paid to you during the Policy Term and all applicable
charges like medical, Stamp Duty, risk etc.
iii) If this product is to be purchased as QROPS (Qualifying Recognized Overseas
Pension Scheme), through transfer of UK tax relieved assets, it would be offered only
to customers who are 55 years of age or above (as on last birthday)
3. Claims Procedure
(1) Benefits payable on Death - The Benefit will be paid if and only if
(i) The death of the Annuitant has occurred (in case of Life Option),
(ii) The deaths of both Annuitants have occurred (in case of Joint Life Option),
(iii) The standard Policy provisions specified in Part F Clause 1 (Exclusions) and Part
F Clause 7 (Incorrect Information and Non Disclosure) are not attracted,
(iv) The Policy has not been surrendered or cancelled or terminated; and
(v) The documents required for processing a claim are:
Basic documentation if death is due to Natural Cause:
a. Completed claim form, (including NEFT details and bank account proof as
specified in the claim form);
b. Original Policy;
c. Original or copy Death Certificate issued by Municipal Authority/ Gram Panchayat
/ Tehsildar (attested by issuing authority);
d. Claimant’s identity and residence proof.
Basic documentation if death is due to Un-Natural Cause:
a. Completed claim form, (including NEFT details and bank account proof as
specified in the claim form);
b. Original Policy;
c. Original or copy Death Certificate issued by Municipal Authority/ Gram Panchayat
/ Tehsildar (attested by issuing authority);
d. Claimant’s identity and residence proof.
e. Original or copy of First Information Report, Police Panchnama report attested by
Police authorities; and
f. Original or copy of Postmortem report attested by Hospital authority.
Critical Illness Claim:
1. Completed claim form, (including NEFT details and bank account proof as
specified in the claim form);
2. Medical records for diagnosis and treatment of the illness
3. Doctor’s / Hospital Certificate
4. Original Policy document / Certificate of Insurance
5. Claimant’s identity and residence proof
Note:
a. In case original documents are submitted, attestation on the document by
authorities is not required.
b. Depending on the circumstances of the death, further documents may be called
for as we deem fit.
(vi) The claim is required to be intimated to us within a period of 90 days from the date
of death. However, we may condone the delay in claim intimation, if any, where
the delay is proved to be for reasons beyond the control of the claimant.
<< (2) Benefits payable on diagnosis of Critical Illness – The Benefit will be paid if and only
if
(i) The Annuitant has been diagnosed with a Critical Illness as specified in Part C
Clause 1 (4) before the age of 85;
(ii) The claim has been intimated to us within 30 days of diagnosis of the Critical
Illness; and
(iii) All relevant documents in support of the claim have been provided to the
Company i.e.
a) Claim form.
b) Original Policy Document.
c) Medical reports or special reports by registered Medical Practitioner
relevant to the Critical Illness and its treatment further validated by a
physician/doctor appointed by the Company.
d) Any other document/ information that the Insurer may decide in the
circumstances of a particular case.
<< (3) Survival Benefit - The Benefit will be paid if and only if
(i) The Annuitant(s) provide(s) proof of survival from time to time The Annuitant(s)
shall provide such proof of survival, as and when called upon to do so. The list of
acceptable proofs will be communicated from time to time. We reserve the right to
suspend the Annuity payments till the proof is provided.>>
4. Assignment
Your Policy cannot be assigned.
5. Nomination The Policyholder/Annuitant can nominate a person(s) in accordance with Section 39
of the Insurance Act, 1938 as amended from time to time. Simplified version of the
provisions of Section 39 is enclosed in Annexure I for reference.
6. Issuance of Duplicate Policy:
The Policyholder can request for a duplicate copy of the Policy at HDFC Life offices
or through Certified Financial Consultant (Insurance Agent) who advised you while
taking this Policy. While making an application for duplicate Policy the Policyholder
is required to submit a notarized original indemnity bond, an affidavit duly stamped
along with KYC documents. Additional charges may be applicable for issuance of the
duplicate Policy.
7. Incorrect Information and Non-Disclosure
Fraud, misrepresentation and forfeiture would be dealt with in accordance with
provisions of Section 45 of the Insurance Act 1938 as amended from time to time.
Simplified version of the provisions of Section 45 is enclosed in Annexure II for
reference
8. Taxes
(1) Indirect Taxes
Tax and levies shall be levied as applicable. Any taxes, statutory levy becoming
applicable in future may become payable by you by any method including by levy of
an additional monetary amount in addition to Premium/Purchase Price and or charges.
(2) Direct Taxes
Tax will be deducted at the applicable rate from the payments made under the Policy,
as per the provisions of the Income Tax Act, 1961.
9. Modification, Amendment, Re-enactment of or to the Insurance laws and
rules, regulations, guidelines, clarifications, circulars etc. thereunder
(1) This Policy is subject to-
(i) The Insurance Act, 1938 as amended from time to time,
(ii) Amendments, modifications (including re-enactment) as may be made from
time to time, and
(iii)Other such relevant Regulations, Rules, Laws, Guidelines, Circulars, Enactments
etc. as may be introduced thereunder from time to time.
(2) We reserve the right to change any of these Policy Provisions / terms and conditions
in accordance with changes in applicable Regulations or Laws, and where required, with
IRDAI’s approval.
(3) We are required to obtain prior approval from the IRDAI before making any material
changes to these provisions, except for changes of regulatory / statutory nature.
(4) We reserve the right to require submission by you of such documents and proof at all
life stages of the Policy as may be necessary to meet the requirements under Anti-
money Laundering/Know Your Customer norms and as may be laid down by IRDAI and
other regulators from time to time.
10. Jurisdiction:
This Policy shall be governed by the laws of India and the Indian Courts shall have
jurisdiction to settle any disputes arising under the Policy.
11. Notices Any notice, direction or instruction given to us, under the Policy, shall be in writing
and delivered by hand, post, facsimile or from registered electronic mail ID to:
HDFC Life Insurance Company Limited, 11th Floor, Lodha Excelus, Apollo Mills
Compound, N.M. Joshi Marg, Mahalaxmi, Mumbai - 400011.
Registered Office: Lodha Excelus, 13th Floor, Apollo Mills Compound, N.M. Joshi
Marg, Mahalaxmi, Mumbai - 400011.
E-mail: [email protected]
Or such other address as may be informed by us.
Similarly, any notice, direction or instruction to be given by us, under the Policy, shall
be in writing and delivered by hand, post, courier, facsimile or registered electronic
mail ID to the updated address in the records of the Company.
You are requested to communicate any change in address, to the Company supported
by the required address proofs to enable the Company to carry out the change of
address in its systems. The onus of intimation of change of address lies with the
Policyholder. An updated contact detail of the Policyholder will ensure that
correspondences from the Company are correctly addressed to the Policyholder at the
latest updated address.
Part G
Grievance Redressal Process
(i) The customer can contact us on the below mentioned address or at any of our
branches in case of any complaint/ grievance:
Grievance Redressal Officer
HDFC Life Insurance Company Limited
11th Floor, Lodha Excelus, Apollo Mills Compound,
N. M. Joshi Marg, Mahalaxmi, Mumbai, Maharashtra - 400011
Helpline number: 18602679999 (Local charges apply)
E-mail: [email protected]
(ii) All grievances (Service and sales) received by the Company will be responded to
within the prescribed regulatory Turn Around Time (TAT) of 15 days.
(iii)Written request or email from the registered email id is mandatory.
(iv) If required, we will investigate the complaints by taking inputs from the customer
over the telephone or through personal meetings.
(v) We will issue an acknowledgement letter to the customer within 3 working days of
the receipt of complaint.
(vi) The acknowledgement that is sent to the customer has the details of the complaint
number, the Policy number and the Grievance Redressal Officer’s name who will be
handling the complaint of the customer.
(vii) If the customer’s complaint is addressed within 3 days, the resolution communication
will also act as the acknowledgment of the complaint.
(viii) The final letter of resolution will offer redressal or rejection of the complaint along
with the appropriate reason for the same.
(ix) In case the customer is not satisfied with the decision sent to him or her, he or she
may contact our Grievance Redressal Officer within 8 weeks of the receipt of the
communication at any of the touch points mentioned in the document, failing which,
we will consider the complaint to be satisfactorily resolved.
(x) The following is the escalation matrix in case there is no response within the
prescribed timelines or if you are not satisfied with the response. The number of days
specified in the below- mentioned escalation matrix will be applicable from the date
of escalation.
Level Designation Response Time
1st Level Associate Vice President –
Customer Relations
10 working days
2nd Level (for response not
received from Level 1)
Sr. Vice President –
Customer Relations
7 working days
You are requested to follow the aforementioned matrix to receive satisfactory response
from us.
(xi) If you are not satisfied with the response or do not receive a response from us within 15
days, you may approach the Grievance Cell of IRDAI on the following contact details:
IRDAI Grievance Call Centre (IGCC) TOLL FREE NO: 155255/ 18004254732
Email ID: [email protected]
Online- You can register your complaint online at http://www.igms.irda.gov.in/
Address for communication for complaints by fax/paper:
General Manager
Consumer Affairs Department – Grievance Redressal Cell
Insurance Regulatory and Development Authority of India
Sy No. 115/1, Financial District,
Nanakramguda, Gachibowli,
Hyderabad – 500 032
2. In the event you are dissatisfied with the response provided by us, you may approach the
Insurance Ombudsman in your region. The details of the existing offices of the Insurance
Ombudsman are provided below. You are requested to refer to the IRDAI website at
“www.irdai.gov.in” for the updated details.
a. Details and addresses of Insurance Ombudsman
Office of the Ombudsman Contact Details Areas of Jurisdiction
AHMEDABAD Office of the Insurance
Ombudsman, Jeevan Prakash
Building, 6th floor, Tilak Marg,
Relief Road, Ahmedabad – 380
001.
Tel.: 079 - 25501201/02/05/06
Email: bimalokpal.ahmedabad@
ecoi.co.in
Gujarat , Dadra &
Nagar Haveli, Daman
and Diu
BHOPAL Office of the Insurance
Ombudsman, Janak Vihar
Complex, 2nd Floor, 6, Malviya
Nagar, Opp. Airtel Office, Near
Madhya Pradesh &
Chhattisgarh
New Market, Bhopal – 462 003.
Tel.: 0755 - 2769201 / 2769202
Fax: 0755 - 2769203
Email:
BHUBANESHWAR Office of the Insurance
Ombudsman, 62, Forest park,
Bhubneshwar – 751 009.
Tel.: 0674 - 2596461 /2596455
Fax: 0674 - 2596429
Email: bimalokpal.bhubaneswar
@ecoi.co.in
Orissa
BENGALURU Office of the Insurance
Ombudsman, Jeevan Soudha
Building, PID No. 57-27-N-19
Ground Floor, 19/19, 24th Main
Road, JP Nagar, Ist Phase,
Bengaluru – 560 078.
Tel.: 080 - 26652048 / 26652049
Email: bimalokpal.bengaluru@e
coi.co.in
Karnataka
CHANDIGARH
Office of the Insurance
Ombudsman, S.C.O. No. 101,
102 & 103, 2nd Floor, Batra
Building, Sector 17 – D,
Chandigarh – 160 017.
Tel.: 0172 - 2706196 / 2706468
Fax: 0172 - 2708274
Email: bimalokpal.chandigarh@
ecoi.co.in
Punjab , Haryana,
Himachal Pradesh,
Jammu & Kashmir ,
Chandigarh
CHENNAI Office of the Insurance
Ombudsman, Fatima Akhtar
Court, 4th Floor, 453, Anna
Salai, Teynampet, CHENNAI –
600 018.
Tel.: 044 - 24333668 / 24335284
Tamil Nadu,
Pondicherry Town and
Karaikal (which are part
of Pondicherry)
Fax: 044 - 24333664
Email: bimalokpal.chennai@ecoi
.co.in
DELHI Office of the Insurance
Ombudsman, 2/2 A, Universal
Insurance Building, Asaf Ali
Road, New Delhi – 110 002.
Tel.: 011 - 23232481 / 23213504
Email: [email protected]
o.in
Delhi
GUWAHATI Office of the Insurance
Ombudsman, Jeevan Nivesh, 5th
Floor, Nr. Panbazar over bridge,
S.S. Road, Guwahati –
781001(ASSAM).
Tel.: 0361 - 2632204 / 2602205
Email: bimalokpal.guwahati@ec
oi.co.in
Assam, Meghalaya,
Manipur, Mizoram,
Arunachal Pradesh,
Nagaland and Tripura
HYDERABAD Office of the Insurance
Ombudsman, 6-2-46, 1st floor,
"Moin Court", Lane Opp. Saleem
Function Palace, A. C. Guards,
Lakdi-Ka-Pool, Hyderabad - 500
004.
Tel.: 040 - 67504123 /
23312122 Fax: 040 - 23376599
Email: bimalokpal.hyderabad@e
coi.co.in
Andhra Pradesh,
Telangana, Yanam and
part of Territory of
Pondicherry
JAIPUR Office of the Insurance
Ombudsman, Jeevan Nidhi – II
Bldg., Gr. Floor, Bhawani Singh
Marg, Jaipur - 302 005.
Tel.: 0141 - 2740363
Email: Bimalokpal.jaipur@ecoi.
co.in
Rajasthan
ERNAKULAM Office of the Insurance Kerala, Lakshadweep,
Ombudsman, 2nd Floor, Pulinat
Bldg., Opp. Cochin Shipyard, M.
G. Road, Ernakulam - 682 015.
Tel.: 0484 - 2358759 / 2359338
Fax: 0484 - 2359336
Email: bimalokpal.ernakulam@e
coi.co.in
Mahe – a part of
Pondicherry
KOLKATA Office of the Insurance
Ombudsman, Hindustan Bldg.
Annexe, 4th Floor, 4, C.R.
Avenue, KOLKATA - 700 072.
Tel.: 033 - 22124339 /
22124340 Fax : 033 - 22124341
Email: bimalokpal.kolkata@ecoi
.co.in
West Bengal, Sikkim,
Andaman & Nicobar
Islands
LUCKNOW Office of the Insurance
Ombudsman, 6th Floor, Jeevan
Bhawan, Phase-II, Nawal Kishore
Road, Hazratganj, Lucknow -
226 001.
Tel.: 0522 - 2231330 / 2231331
Fax: 0522 - 2231310
Email: bimalokpal.lucknow@ec
oi.co.in
Districts of Uttar
Pradesh : Laitpur,
Jhansi, Mahoba,
Hamirpur, Banda,
Chitrakoot, Allahabad,
Mirzapur, Sonbhabdra,
Fatehpur, Pratapgarh,
Jaunpur,Varanasi,
Gazipur, Jalaun,
Kanpur, Lucknow,
Unnao, Sitapur,
Lakhimpur, Bahraich,
Barabanki, Raebareli,
Sravasti, Gonda,
Faizabad, Amethi,
Kaushambi, Balrampur,
Basti, Ambedkarnagar,
Sultanpur,
Maharajgang,
Santkabirnagar,
Azamgarh, Kushinagar,
Gorkhpur, Deoria, Mau,
Ghazipur, Chandauli,
Ballia, Sidharathnagar
MUMBAI Office of the Insurance
Ombudsman, 3rd Floor, Jeevan
Seva Annexe, S. V. Road,
Santacruz (W), Mumbai - 400
054.
Tel.: 022 - 26106552 / 26106960
Fax: 022 - 26106052
Email: bimalokpal.mumbai@eco
i.co.in
Goa, Mumbai
Metropolitan Region
excluding Navi Mumbai
& Thane
NOIDA Office of the Insurance
Ombudsman, Bhagwan Sahai
Palace 4th Floor, Main Road,
Naya Bans, Sector 15, Distt:
Gautam Buddh Nagar, U.P-
201301.
Tel.: 0120-2514250 / 2514252 /
2514253
Email: [email protected]
o.in
State of Uttaranchal and
the following Districts
of Uttar Pradesh: Agra,
Aligarh, Bagpat,
Bareilly, Bijnor,
Budaun, Bulandshehar,
Etah, Kanooj, Mainpuri,
Mathura, Meerut,
Moradabad,
Muzaffarnagar,
Oraiyya, Pilibhit,
Etawah, Farrukhabad,
Firozbad,
Gautambodhanagar,
Ghaziabad, Hardoi,
Shahjahanpur, Hapur,
Shamli, Rampur,
Kashganj, Sambhal,
Amroha, Hathras,
Kanshiramnagar,
Saharanpur
PATNA
Office of the Insurance
Ombudsman, 1st Floor,Kalpana
Arcade Building, Bazar Samiti
Road, Bahadurpur, Patna 800
006. Tel.: 0612-2680952
Email:
Bihar, Jharkhand
PUNE Office of the Insurance
Ombudsman, Jeevan Darshan
Bldg., 3rd Floor, C.T.S. No.s. 195
to 198, N.C. Kelkar Road,
Narayan Peth, Pune – 411 030.
Tel.: 020-41312555
Email: [email protected]
.in
Maharashtra, Area of
Navi Mumbai and
Thane excluding
Mumbai Metropolitan
Region
b. Power of Ombudsman-
1) The Ombudsman shall receive and consider complaints or disputes relating to—
(a) delay in settlement of claims, beyond the time specified in the regulations, framed
under the Insurance Regulatory and Development Authority of India Act, 1999;
(b) any partial or total repudiation of claims by the Company ;
(c) disputes over Premium paid or payable in terms of insurance Policy;
(d) misrepresentation of Policy terms and conditions at any time in the Policy document
or Policy contract;
(e) legal construction of insurance policies in so far as the dispute relates to claim;
(f) Policy servicing related grievances against insurers and their agents and
intermediaries;
(g) issuance of life insurance Policy, general insurance Policy including health insurance
Policy which is not in conformity with the proposal form submitted by the proposer;
(h) non-issuance of insurance Policy after receipt of Premium in life insurance; and
(i) any other matter resulting from the violation of provisions of the Insurance Act, 1938,
as amended from time to time, or the regulations, circulars, guidelines or instructions
issued by the IRDAI from time to time or the terms and conditions of the Policy
contract, in so far as they relate to issues mentioned at clauses (a) to (f).
2) The Ombudsman shall act as counsellor and mediator relating to matters specified in sub-
rule (1) provided there is written consent of the parties to the dispute.
3) The Ombudsman shall be precluded from handling any matter if he is an interested party
or having conflict of interest.
4) The Central Government or as the case may be, the IRDAI may, at any time refer any
complaint or dispute relating to insurance matters specified in sub-rule (1), to the
Insurance Ombudsman and such complaint or dispute shall be entertained by the
Insurance Ombudsman and be dealt with as if it is a complaint made under Clause (c)
provided herein below.
c. Manner in which complaint is to be made -
1) Any person who has a grievance against the Company, may himself or through his legal
heirs, nominee or assignee, make a complaint in writing to the Insurance Ombudsman
within whose territorial jurisdiction the branch or office of the Company complained
against or the residential address or place of residence of the complainant is located.
2) The complaint shall be in writing, duly signed by the complainant or through his legal
heirs, nominee or assignee and shall state clearly the name and address of the
complainant, the name of the branch or office of the Company against whom the
complaint is made, the facts giving rise to the complaint, supported by documents, the
nature and extent of the loss caused to the complainant and the relief sought from the
Insurance Ombudsman.
3) No complaint to the Insurance Ombudsman shall lie unless—
(a) the complainant makes a written representation to the Company named in the
complaint and—
i. either the Company had rejected the complaint; or
ii. the complainant had not received any reply within a period of one month after the
Company received his representation; or
iii. the complainant is not satisfied with the reply given to him by the Company;
(b) The complaint is made within one year—
i. after the order of the Company rejecting the representation is received; or
ii. after receipt of decision of the Company which is not to the satisfaction of the
complainant;
iii. after expiry of a period of one month from the date of sending the written
representation to the Company if the Company fails to furnish reply to the
complainant.
4) The Ombudsman shall be empowered to condone the delay in such cases as he may
consider necessary, after calling for objections of the Company against the proposed
condonation and after recording reasons for condoning the delay and in case the delay is
condoned, the date of condonation of delay shall be deemed to be the date of filing of the
complaint, for further proceedings under these rules.
5) No complaint before the Insurance Ombudsman shall be maintainable on the same subject
matter on which proceedings are pending before or disposed of by any court or consumer
forum or arbitrator.
Annexure I
Section 39 - Nomination by policyholder Nomination of a life insurance Policy is as below in accordance with Section 39 of the
Insurance Act, 1938 as amended by Insurance Laws (Amendment) Act, 2015 dated
23.03.2015. The extant provisions in this regard are as follows:
1) The policyholder of a life insurance on his own life may nominate a person or persons to
whom money secured by the policy shall be paid in the event of his death.
2) Where the nominee is a minor, the policyholder may appoint any person to receive the
money secured by the policy in the event of policyholder’s death during the minority of
the nominee. The manner of appointment to be laid down by the insurer.
3) Nomination can be made at any time before the maturity of the policy.
4) Nomination may be incorporated in the text of the policy itself or may be endorsed on the
policy communicated to the insurer and can be registered by the insurer in the records
relating to the policy.
5) Nomination can be cancelled or changed at any time before policy matures, by an
endorsement or a further endorsement or a will as the case may be.
6) A notice in writing of Change or Cancellation of nomination must be delivered to the
insurer for the insurer to be liable to such nominee. Otherwise, insurer will not be liable if
a bonafide payment is made to the person named in the text of the policy or in the
registered records of the insurer.
7) Fee to be paid to the insurer for registering change or cancellation of a nomination can be
specified by the Authority through Regulations.
8) On receipt of notice with fee, the insurer should grant a written acknowledgement to the
policyholder of having registered a nomination or cancellation or change thereof.
9) A transfer or assignment made in accordance with Section 38 shall automatically cancel
the nomination except in case of assignment to the insurer or other transferee or assignee
for purpose of loan or against security or its reassignment after repayment. In such case,
the nomination will not get cancelled to the extent of insurer’s or transferee’s or
assignee’s interest in the policy. The nomination will get revived on repayment of the
loan.
10) The right of any creditor to be paid out of the proceeds of any policy of life insurance
shall not be affected by the nomination.
11) In case of nomination by policyholder whose life is insured, if the nominees die before
the policyholder, the proceeds are payable to policyholder or his heirs or legal
representatives or holder of succession certificate.
12) In case nominee(s) survive the person whose life is insured, the amount secured by the
policy shall be paid to such survivor(s).
13) Where the policyholder whose life is insured nominates his (a) parents or (b) spouse or
(c) children or (d) spouse and children (e) or any of them; the nominees are beneficially
entitled to the amount payable by the insurer to the policyholder unless it is proved that
policyholder could not have conferred such beneficial title on the nominee having regard
to the nature of his title.
14) If nominee(s) die after the policyholder but before his share of the amount secured under
the policy is paid, the share of the expired nominee(s) shall be payable to the heirs or
legal representative of the nominee or holder of succession certificate of such nominee(s).
15) The provisions of sub-section 7 and 8 (13 and 14 above) shall apply to all life insurance
policies maturing for payment after the commencement of Insurance Laws (Amendment)
Act, 2015.
16) If policyholder dies after maturity but the proceeds and benefit of the policy has not been
paid to him because of his death, his nominee(s) shall be entitled to the proceeds and
benefit of the policy.
17) The provisions of Section 39 are not applicable to any life insurance policy to which
Section 6 of Married Women’s Property Act, 1874 applies or has at any time applied
except where before or after Insurance Laws (Amendment) Act, 2015, a nomination is
made in favour of spouse or children or spouse and children whether or not on the face of
the policy it is mentioned that it is made under Section 39. Where nomination is intended
to be made to spouse or children or spouse and children under Section 6 of MWP Act, it
should be specifically mentioned on the policy. In such a case only, the provisions of
Section 39 will not apply.
[Disclaimer: This is not a comprehensive list of amendments of Insurance Laws
(Amendment) Act, 2015 and only a simplified version prepared for general information.
Policy Holders are advised to refer to Insurance Laws (Amendment) Act, 2015dated
23.03.2015 for complete and accurate details.]
Annexure II
Section 45 – Policy shall not be called in question on the ground of mis-statement after
three years
Provisions regarding policy not being called into question in terms of Section 45 of the
Insurance Act, 1938, as amended by Insurance Laws (Amendment) Act, 2015 dated
23.03.2015are as follows:
1) No Policy of Life Insurance shall be called in question on any ground whatsoever after
expiry of 3 yrs from
a. the date of issuance of policy or
b. the date of commencement of risk or
c. the date of revival of policy or
d. the date of rider to the policy
whichever is later.
2) On the ground of fraud, a policy of Life Insurance may be called in question within 3
years from
a. the date of issuance of policy or
b. the date of commencement of risk or
c. the date of revival of policy or
d. the date of rider to the policy
whichever is later.
For this, the insurer should communicate in writing to the insured or legal representative
or nominee or assignees of insured, as applicable, mentioning the ground and materials on
which such decision is based.
3) Fraud means any of the following acts committed by insured or by his agent, with the
intent to deceive the insurer or to induce the insurer to issue a life insurance policy:
a. The suggestion, as a fact of that which is not true and which the insured does not
believe to be true;
b. The active concealment of a fact by the insured having knowledge or belief of the fact;
c. Any other act fitted to deceive; and
d. Any such act or omission as the law specifically declares to be fraudulent.
4) Mere silence is not fraud unless, depending on circumstances of the case, it is the duty of
the insured or his agent keeping silence to speak or silence is in itself equivalent to speak.
5) No Insurer shall repudiate a life insurance Policy on the ground of Fraud, if the Insured /
beneficiary can prove that the misstatement was true to the best of his knowledge and
there was no deliberate intention to suppress the fact or that such mis-statement of or
suppression of material fact are within the knowledge of the insurer. Onus of disproving
is upon the policyholder, if alive, or beneficiaries.
6) Life insurance Policy can be called in question within 3 years on the ground that any
statement of or suppression of a fact material to expectancy of life of the insured was
incorrectly made in the proposal or other document basis which policy was issued or
revived or rider issued. For this, the insurer should communicate in writing to the insured
or legal representative or nominee or assignees of insured, as applicable, mentioning the
ground and materials on which decision to repudiate the policy of life insurance is based.
7) In case repudiation is on ground of mis-statement and not on fraud, the premium collected
on policy till the date of repudiation shall be paid to the insured or legal representative or
nominee or assignees of insured, within a period of 90 days from the date of repudiation.
8) Fact shall not be considered material unless it has a direct bearing on the risk undertaken
by the insurer. The onus is on insurer to show that if the insurer had been aware of the
said fact, no life insurance policy would have been issued to the insured.
9) The insurer can call for proof of age at any time if he is entitled to do so and no policy
shall be deemed to be called in question merely because the terms of the policy are
adjusted on subsequent proof of age of life insured. So, this Section will not be applicable
for questioning age or adjustment based on proof of age submitted subsequently.
[Disclaimer: This is not a comprehensive list of amendments of Insurance Laws
(Amendment) Act, 2015 and only a simplified version prepared for general information.
Policy Holders are advised to refer to Insurance Laws (Amendment) Act, 2015 dated
23.03.2015 for complete and accurate details.]